Common Assisted
Reproductive Technology (ART) Q & A


Introduction To Common Nursing Questions:
The nurses at SRMS receive hundreds of phone calls each week from our own patients and interested individuals. This Q & A section was designed to try to answer some of the more common questions asked by patients. We suggest that you review the ART Q&A below, and if not covered here, feel free to call our office. Depending upon the nature of the question, we ask that you be patient with a return call. We try to answer questions within hours but may take as long as three business days for non-emergent/urgent inquiries. If you feel there are questions that we have missed, please let us know.

How long will it take for our ART "work-up" to be completed?
Many of the tests required prior to ART are related to you menstrual cycle. The average preparation time is about one to two months. Don’t forget that some of the testing might already have been completed recently (within the past 1-2 years) and will not be re-tested. The ART process is labor intensive. It is encouraged that you read all provided materials -- don't memorize them, simply become familiar with the process.

How often does SRMS run ART cycles and when can we start?
We currently run seven ART cycles each year that last 4 weeks each. In between those cycles, we complete the work-up on the upcoming set of patients and evaluate the previous cycle's statistics.

When will we start the ART procedure?
Within the confines of the ART cycle dates, everyone will start on one of two or three dates.

How many times can we undergo ART?
Depending upon your age and how well your ovaries respond to the medications, we have no actual limit. How many times a couple wishes to attempt a particular procedure before going on to other options will be discussed with the patients by their physician. Our only guide is that we will not recommend repeat procedures unless there is a reasonable chance for success. Psychological counseling may be recommended to patients whose expectations seem to be beyond their physiologic abilities.

Do our chances for success decrease for every procedure we undergo? In general, the chances for success will be similar for the first four consecutive cycles. It is rare, fortunately, that any of our patients have to go much beyond two fresh cycles with one or two frozen embryo transfers thrown in.

What are the chances of having twins? We want twins -- can you promise us a twin pregnancy?
We cannot guarantee that you will conceive, much less provide you with a twin pregnancy. We try to achieve a singleton pregnancy but overshoot frequently.

The chances for a multiple pregnancy depends upon your age, the procedure performed and the number/quality of the embryos transferred. That stated, out of those who do become pregnant through ART, about 50% will have more than one gestation. Fortunately, the vast majority will have twins. Please understand that a twin pregnancy is a high-risk pregnancy, so we really work at one gestation at a time.

How will we know what mediations to take and when to take them?
Before any patient starts their medications, they will be given detailed written instructions as well as a "hands-on" demonstration on how to mix and inject all medications.

We will take you by the hand and instruct you step-by-step through the ART process, as we have done since 1992.

When can we find out if we're pregnant?
Approximately nine days after the embryos are transferred, a blood pregnancy test will be done. Up to that point in time, urine pregnancy tests may not be accurate, so don't slip any in.

Why does the male partner have to provide two semen specimens for analysis and why can't we take them to any lab?
We require two specimens to be tested prior to the start of your ART cycle. The first analysis will include an antibody screen, which outside labs do not perform. The second analysis includes a culture, which will be sent to the lab of your choice. We need to be sure that there is no underlying infection that could impede fertilization and a successful pregnancy. Because of the importance of your ART cycle and the amount of effort and expense incurred, fertilization technique decisions are based on the combined semen data.

How much will the ART cycle cost?
The exact cost of the ART process will depend on how much reimbursement you will get from your insurance company. The average cost from the first visit, all necessary evaluation, stimulation medications, egg retrieval, anesthesia, laboratory fees and transfer fees come close to $17,000. The only costs that may not be factored include prolonged frozen embryo cryopreservation fees, which vary depending upon the duration of storage.

In comparing different programs, please make certain that you are comparing "apples to apples". As an example, we do not charge extra for such procedures as assisted hatching. Some programs do not include the evaluation costs or the medication costs in their price quotes, so be thoughtful.

Will our insurance cover our ART procedure?
Many insurance companies are covering some of the office procedures and laboratory testing leading up to the egg retrieval itself. Some companies even cover the whole ART process, depending upon the coverage purchased by your employer. We will gladly assist you in determining the amount of coverage available before the procedure.

Even after the insurance company states that the service will be covered, we have had a couple of episodes wherein they came back after the procedures and stated that the procedures were not covered.

Please discuss any financial concerns you have with the front office before initiating your cycle.